The Role of Hyperbaric Oxygen Treatment for COVID-19: A Review

Paganini, Matteo; Bosco, Gerardo; Perozzo, Filippo Andrea Giovanni; Kohlscheen, Eva; Sonda, Regina; Bassetto, Franco; Garetto, G; Camporesi, Enrico M.; Thom, Stephen R.

doi:10.1007/5584_2020_568

Cited by 39 publications

(40 citation statements)

References 48 publications

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“…Fever has been recognized as the most common symptom of hospitalized COVID-19 patients ( Benussi et al, 2020 ; Ng et al, 2020 ; Qiu et al, 2020 ; Wang et al, 2020 ). Oxygen therapy has been widely taken for COVID-19 patients ( Barrett et al, 2020 ; Hassan et al, 2020 ; Kayem et al, 2020 ; Liu et al, 2020 ; Paganini et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Alterations of frontal-temporal gray matter volume associate with clinical measures of older adults with COVID-19

Duan

Premi

Padovani

et al. 2021

Neurobiology of Stress

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COVID-19, the infectious disease caused by the most recently discovered severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become a global pandemic. It dramatically affects people's health and daily life. Neurological complications are increasingly documented for patients with COVID-19. However, the effect of COVID-19 on the brain is less studied, and existing quantitative neuroimaging analyses of COVID-19 were mainly based on the univariate voxel-based morphometry analysis (VBM) that requires corrections for a large number of tests for statistical significance, multivariate approaches that can reduce the number of tests to be corrected have not been applied to study COVID-19 effect on the brain yet. In this study, we leveraged source-based morphometry (SBM) analysis, a multivariate extension of VBM, to identify changes derived from computed tomography scans in covarying gray matter volume patterns underlying COVID-19 in 120 neurological patients (including 58 cases with COVID-19 and 62 patients without COVID-19 matched for age, gender and diseases). SBM identified that lower gray matter volume (GMV) in superior/medial/middle frontal gyri was significantly associated with a higher level of disability (modified Rankin Scale) at both discharge and six months follow-up phases even when controlling for cerebrovascular diseases. GMV in superior/medial/middle frontal gyri was also significantly reduced in patients receiving oxygen therapy compared to patients not receiving oxygen therapy. Patients with fever presented significant GMV reduction in inferior/middle temporal gyri and fusiform gyrus compared to patients without fever. Patients with agitation showed GMV reduction in superior/medial/middle frontal gyri compared to patients without agitation. Patients with COVID-19 showed no significant GMV differences from patients without COVID-19 in any brain region. Results suggest that COVID-19 may affect the frontal-temporal network in a secondary manner through fever or lack of oxygen.

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Section: Discussionmentioning

confidence: 99%

Alterations of frontal-temporal gray matter volume associate with clinical measures of older adults with COVID-19

Duan

Premi

Padovani

et al. 2021

Neurobiology of Stress

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“…Moreover, all these facts have shed a light on finding better treatments to prevent fast hypoxia, fatality or even the need for mechanical ventilation [ 143 , 144 ] being HBOT a suggested adjuvant for its promising outcomes from previous animal models and clinical cases of sepsis and inflammatory diseases [ 145 ]. Preliminary comparisons of HBOT applications in COVID-19 to other maladies, like livedoid vasculopathy, have exposed the possible mechanisms that may occur: anti-inflammatory actions (decreased ICAM-1, proinflammatory cytokines and neutrophil rolling), anticoagulant actions (boosted fibrinolysis and increased plasminogen activator) and tissue healing actions (increased fibroblasts and stem cells) [ 146 ].…”

Section: Translational and Potential Applications Of Hbotmentioning

confidence: 99%

A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities

et al. 2021

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Hyperbaric oxygen therapy (HBOT) consists of using of pure oxygen at increased pressure (in general, 2–3 atmospheres) leading to augmented oxygen levels in the blood (Hyperoxemia) and tissue (Hyperoxia). The increased pressure and oxygen bioavailability might be related to a plethora of applications, particularly in hypoxic regions, also exerting antimicrobial, immunomodulatory and angiogenic properties, among others. In this review, we will discuss in detail the physiological relevance of oxygen and the therapeutical basis of HBOT, collecting current indications and underlying mechanisms. Furthermore, potential areas of research will also be examined, including inflammatory and systemic maladies, COVID-19 and cancer. Finally, the adverse effects and contraindications associated with this therapy and future directions of research will be considered. Overall, we encourage further research in this field to extend the possible uses of this procedure. The inclusion of HBOT in future clinical research could be an additional support in the clinical management of multiple pathologies.

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“…The hypothesis of HBO as a safe and effective treatment and possible mechanisms has been previously published. [24][25][26] Published case series from China and the USA indicate that HBO in these patients may be safe and beneficial. [27][28][29][30] A propensity-matched control study (n=20) from the USA showed 50% lower mortality and almost two-thirds less need for mechanical ventilation in the HBO-treated group.…”

Section: Open Accessmentioning

confidence: 99%

Randomised, controlled, open label, multicentre clinical trial to explore safety and efficacy of hyperbaric oxygen for preventing ICU admission, morbidity and mortality in adult patients with COVID-19

et al. 2021

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IntroductionCOVID-19 may cause severe pneumonitis and trigger a massive inflammatory response that requires ventilatory support. The intensive care unit (ICU)-mortality has been reported to be as high as 62%. Dexamethasone is the only of all anti-inflammatory drugs that have been tested to date that has shown a positive effect on mortality. We aim to explore if treatment with hyperbaric oxygen (HBO) is safe and effective for patients with severe COVID-19. Our hypothesis is that HBO can prevent ICU admission, morbidity and mortality by attenuating the inflammatory response. The primary objective is to evaluate if HBO reduces the number of ICU admissions compared with best practice treatment for COVID-19, main secondary objectives are to evaluate if HBO reduces the load on ICU resources, morbidity and mortality and to evaluate if HBO mitigates the inflammatory reaction in COVID-19.Methods and analysisA randomised, controlled, phase II, open label, multicentre trial. 200 subjects with severe COVID-19 and at least two risk factors for mortality will be included. Baseline clinical data and blood samples will be collected before randomisation and repeated daily for 7 days, at days 14 and 30. Subjects will be randomised with a computer-based system to HBO, maximum five times during the first 7 days plus best practice treatment or only best practice treatment. The primary endpoint, ICU admission, is defined by criteria for selection for ICU. We will evaluate if HBO mitigates the inflammatory reaction in COVID-19 using molecular analyses. All parameters are recorded in an electronic case report form. An independent Data Safety Monitoring Board will review the safety parameters.Ethics and disseminationThe trial is approved by The National Institutional Review Board in Sweden (2020-01705) and the Swedish Medical Product Agency (5.1-2020-36673). Positive, negative and any inconclusive results will be published in peer-reviewed scientific journals with open access.Trial registrationNCT04327505. EudraCT number: 2020-001349-37.

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The Role of Hyperbaric Oxygen Treatment for COVID-19: A Review

Cited by 39 publications

References 48 publications

Alterations of frontal-temporal gray matter volume associate with clinical measures of older adults with COVID-19

Alterations of frontal-temporal gray matter volume associate with clinical measures of older adults with COVID-19

A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities

Randomised, controlled, open label, multicentre clinical trial to explore safety and efficacy of hyperbaric oxygen for preventing ICU admission, morbidity and mortality in adult patients with COVID-19

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